Organization
CARY CHURCH OF GOD
Active
Other names
R3 Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAN TIREY (OFFICE MANAGER)
(919) 467-0537
Entity
Organization
Contact information
Practice address
107 QUADE DR, CARY, NC 27513-7401
(919) 467-0537
Mailing address
107 QUADE DR, CARY, NC 27513-7401
(919) 467-0537
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
A12861
NC
2084P0800X
Psychiatry Physician
Primary
2014-01031
NC
Other
Enumeration date
04/18/2017
Last updated
04/18/2017
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